Connected devices promise to deliver much better healthcare provision

The Internet of Things represents an enormous opportunity for the healthcare sector, but security should be a major concern, writes Neil McLellan, Senior Manager for Medical Platforms at Wind River.

Healthcare executives contemplate many difficult strategic issues every day. Devising a “connectivity strategy” typically isn’t one of them. It should be. That’s because increasing the connectivity of devices and data can help resolving many of the most pressing challenges the healthcare industry faces. Healthcare costs continue to spiral upward, while the average lifespan continues to increase. The cost of medical equipment is also rising; physician salaries and staff costs are increasing; facilities expenditures are growing. The best way to significantly cut healthcare costs is to increase efficiency and productivity, and the best way to do that is to harness device intelligence to streamline and automate tasks, reducing the need for high-cost, time-consuming manual processes, while effectively lowering risks contributed by human error.

Rural areas have less direct access to physicians. For example, in Germany 55% of the population live in cities, 25% live in rural areas and the rest live in areas with a trend to high urbanisation. Almost all citizens in Germany have access to local medical services and the healthcare infrastructure is still comprehensively active and profitable throughout the country. Like many countries however, there is an ageing population and local migration has started to change the situation dramatically in rural areas. The challenge is balancing the healthcare provision for young persons that have migrated to prosperous and urban areas compared to supporting an increasingly older, less healthy population in rural areas.

Telemedicine solutions can help solve the issue by increasing access without requiring physical presence—so rural patients can receive the right care at the right time, reducing missed diagnosis and associated complications.

The Internet of Things is increasing the opportunities for creating innovative new healthcare services. By 2020 there will be 75 billion devices connected to IoT, according to Morgan Stanley. Yet today, more than 99 percent of things in the physical world are still not connected to the Internet. The combination of these two facts represents an enormous opportunity for the healthcare industry. Throughout history, more connectivity has always led to more innovation—and though we can’t predict the scope and magnitude of the change that results, innovation always leads to great things—for people and for businesses.

Consumers are asserting greater control over their own course of care. Through the web, search engines, social media, and online healthcare services, consumers now have instant access to huge volumes of medical information, diagnosis tools, and instant access to the opinions and experiences of others. This level of connectivity will continue to increase, changing the traditional business model for healthcare providers.

Telemedicine makes it possible to receive care without having to visit a physician or a care facility in person. There are multiple forms of telemedicine, including remote monitoring of patient data; transmission of medical images and electronic records to physicians so that they have access when needed; or real-time interactive visits via teleconferencing, online chat, or other channels. And what makes telemedicine possible is device connectivity.

The recent surge in “pop-up clinics,” remote consultation services, and remote point-of-care offerings underscores the fast-growing appeal of telemedicine services among patients and caregivers alike. For patients, telemedicine offers care in an on-demand fashion, removing the need for lengthy and inconvenient sitting in the waiting room without compromising on the quality of care. For doctors it shifts the workflow to a more convenient time so that they can prioritize their work appropriately; and for hospitals and clinics it accelerates the workload and cuts costs while also improving the patient’s experience and satisfaction.

It is important to note that financial support for telemedicine is also increasing. In the US there are provisions for paying for remote chronic care management using a new current procedural terminology (CPT) code. In Europe, there is a CPT code for telemonitoring of pacemaker patients in place but a general one for telemedicine only exists in Spain so far.

The more devices and data are connected, the faster and more accurate diagnosis becomes. Mobile devices already give physicians access to any type of information they need in seconds—from patient records to drug information to recent research and studies—all of which accelerates an accurate diagnosis. In addition, new applications are constantly being developed to aid in everything from reading X-rays and CT scans to proactively identifying emerging health threats.

Equally important, this access to information gives consumers the ability to perform an initial self-diagnosis with a high degree of accuracy. They can access huge online medical databases, use commercial online diagnosis services, and tap into the combined knowledge and experiences of millions of people via social media.

Connected devices and integrated, intelligent machines can also improve the quality of treatment. For example, robotic surgeries are now possible, and in some cases the physician does not even need to be in the operating room when the surgery is performed. Surgeons can operate remotely and patients can have the procedure done in a convenient location, sometimes avoiding the need to travel to a specific hospital or clinic, which dramatically increases access to specialist care in rural areas. This technology is also applied to create minimally invasive procedures that reduce scarring, chance of infection, and recovery times.

Another healthcare priority is to put more emphasis on prevention rather than cure. Today the balance is significantly towards cure rather than prevention. Connected devices can help change that balance. For example, wearable devices such as home ECG sensors or Fitbit activity monitors make it possible for consumers to track their daily activities as part of personal health plans that are aimed at increasing healthy decisions and preventing health issues. In addition, connectivity provides a way to securely aggregate data from patients’ electronic medical records, personal health devices and other telemetrics—and deliver new services to patients on their mobile devices.

A critical first step is to consider the core attributes connected devices must provide—both from a business perspective and from a technical perspective—in order to deliver on the demands of the connected healthcare vision. One of the most important aspects of delivering this vision is interoperability. Medical devices are increasingly connected to public networks for a wide range of applications. This means they need to support a wide range of communications standards and protocols such as CAN, Bluetooth, Continua, 802.15.4, Wi-Fi, and Ethernet—and deliver high-perfor¬mance networking capabilities out of the box. In addition, diverse types of devices must be able to connect via wireless and wired networks and interoperate with each other and with existing devices and data. This is particularly critical for medical applications that will incorporate big data and analytics, as the sources of data are highly varied and geographically distributed.

Security is the overarching concern in the connected era. Devices must provide comprehensive and tightly integrated security capabilities that ensure patient privacy and confidentiality; protect the integrity and availability of data; guard against advanced threats such as malware, “zero-day” attacks, and viruses such as the Heartbleed virus; and ward off other sophisticated attacks and attackers. In addition, medical device system software needs to deliver secure data storage and transmission and tamper-proof designs. OS-level support for these features is critical, since adding them at the user or application level is ineffective, expen-sive, and risky. And, since security threats are ever-changing, the system software needs to support the secure upgrade, download, and authentication of applications to help keep devices secure going forward.

Obviously, safety is paramount for medical devices because malfunctions could cause injury or death—but not all medical device applications are equally life-critical. Connected devices should allow multiple applications with different levels of criticality to run on the same hardware platform; and adding new functionality or making changes in tools and technologies must not compromise the safety of the device. The hardware and software of medical devices must meet stringent regulatory guidelines for safety such as the EN60601 3rd edition for power supplies.

With an increasing emphasis on personal health awareness and prevention, the connected world of the IoT has the potential to have a transformative affect on healthcare provision.

Wind River